Presentation Authors: Fernando Caumont*, Katherine Levie, Jason Frankel, John Paul Flores, Seattle, WA, Timothy Brand, Tacoma, WA, Inger Rosner, Bethesda, MD, Sean Stroup, San Diego, CA, John Musser, Honolulu, HI, Claire Kuo, Jennifer Cullen, Rockville, MD, Christopher Porter, Seattle, WA
Introduction: This study aimed to determine the effect of secondary radiotherapy (RT) after radical prostatectomy (RP) on prospectively measured Health Related Quality of Life (HRQoL) in prostate cancer (PCa) patients. The primary study hypothesis was that men undergoing EBRT after RP (RP+XRT) report lower HRQoL compared to men who received RP only, in a time dependent manner.
Methods: Enrollees in the Center for Prostate Disease Research (CPDR) Multi-center National Database diagnosed with PCa (2007-2017) and receiving RP as 1st treatment were eligible. Expanded Prostate Cancer Index Composite and RAND 36 Item Short Form Health Survey (SF-36) were completed at pre-treatment and regular intervals. Men with HRQoL data at baseline and â‰¥1 year follow up were included. Time to RT after RP was determined. Temporal changes in HRQoL were compared for low, intermediate and high risk (NCCN criteria) PCa patients managed with RT after RP at baseline, 12 and 24 months. Longitudinal patterns were modeled using generalized estimating equations for repeated measures, adjusting for baseline HRQoL, demographic and clinical patient characteristics.
Results: 472 eligible PCa men underwent RP; 394 (83.5%) received only RP; 49 (10.4%) received RP+XRT (18 had RT at â‰¤ 1 year; 31 at 1-5 years). Mean time to secondary RT was 1.2 yrs. At baseline both groups reported comparable HRQoL. At 24 months RP+XRT men had worse scores in bowel domains, but no difference in Bowel Function (p=0.25) and close to significance in Bowel Bother p=0.06) compared to RP only. Conversely, hormonal domains were better at the same time point and significantly different in Hormonal Function (p=0.04). There were no differences in urinary, sexual, mental or physical performance on SF-36 between groups. Longitudinal analysis from baseline in the RP+XRT group showed a decline in sexual and urinary domains at 12 months, but a trend to improve at 24 months. No changes were observed at 12 months in bowel and hormonal domains, with improvement for hormonal domains and decline in bowel domains at 24 months, Fig. 1.
Conclusions: The use of RT for biochemical recurrent PCa after RP is safe. Similar results were found in urinary, hormonal and sexual domains between groups. Patients should be counseled about bowel effects of RT on HRQoL outcomes when considering RT after RP.
Source of Funding: This work was performed under the Cooperative Research Agreement Funds with Uniformed Services University for the Health Sciences. (Award # HU0001-10-2-0002)